人感染禽流感家庭聚集性病例研究进展

1997年以来，全球多个国家相继出现人感染H5N1禽流感家庭聚集性病例，随后中国局部地区也陆续报告了人感染H7N9禽流感相关病例。目前存在的人传人的现象是有限非持续的，具体的人际间传播途径与方式并不清楚且尚无证据证实上述2种病毒可以在人间持续传播。家庭聚集性病例多发生在与禽类接近或接触的人群中，可能存在的遗传易感性以及个体间受体表达的差异增加了家庭成员感染禽流感病毒的风险。随着人感染H5N1与H7N9禽流感病毒的持续流行以及病毒自身变异的发生，不排除其获得对人类的适应性突变可能性。人感染H7N9病例中未检测出的症状轻微感染者可能会引起更难以控制的人际间流行。本文将从人感染H5N1、H7N9病毒家庭聚集性病例的流行病学特征、传播模式以及传播能力等方面进行系统阐述，为今后禽流感疫情的防控提供一定的科学依据。

Advances in family clusters cases of human infection with avian influenza

Family clusters of H5N1 virus infection have been found in many countries around the world since 1997. Subsequently, local areas in China also have reported family clusters of H7N9 virus infection. The current phenomenon of human-to-human transmission is limited and unsustainable. In addition, the specific way and mode of transmission is not clear and there is no evidence that the two viruses can continue to spread among the people. Family clustered cases occur mainly in populations who close to or in contact with poultry. The possible genetic susceptibility and the difference between individual recept expression increases the risk of family members infected with avian influenza virus. With the persistence of human infection with H5N1 and H7N9 avian influenza virus and the occurrence of viral mutations, it does not rule out the possibility of obtaining adaptive mutations to humans. What is the more important, cases who have undetected symptoms in the H7N9 virus may cause uncontrollable interpersonal prevalence. In this paper, the epidemiological characteristics, transmission patterns and communication capacity of the human infection H5N1 and H7N9 virus family clustering cases were elaborated, which were helpful to provide the scientific evidence for prevention and control in avian influenza epidemic.